Maxillary Sinus Clinical Trial
Official title:
Comparative Study Between Effect of Buccal Fat Pad and Platelet Rich Fibrin After Ultrasonic Hydrodynamic Maxillary Sinus Membrane Elevation
Placing implants in the posterior maxillary area has the drawback of working with scarce,
poor quality bone in a significant percentage of cases. Numerous advanced surgical techniques
have been developed to overcome the difficulties associated with these limitations.
Subsequent to reports on the elevation of the maxillary sinus through the lateral approach,
there were reports on the use of the crestal approach, which is less aggressive but requires
a minimal amount of bone. Furthermore, it is more sensitive to operator technique, as the
integrity of the sinus membrane is checked indirectly. The main advantage of this new
technique, Intralift, is that it does not require a minimum amount of crestal bone (indeed,
the smaller the width of the crestal bone, the better this technique is performed). The
possibility of damage to the sinus membrane is minimized by using ultrasound based
hydrodynamic pressure to lift it, while applying a very non-aggressive crestal approach.
Conclusions: We believe that this technique is an advance in the search for less traumatic
and aggressive techniques, which is the hallmark of current surgery The buccal fat pad
appears at 3 months in utero and continuously grows until birth (9). It protrudes at the
anterior border of the masseter muscle and extends to the parotid duct, where it rests on the
buccopharyngeal fascia, which covers the buccinator muscle. There is little change in the
volume of buccal fat during aging, and it is approximately 10 mL
PRF is a natural fibrin-based biomaterial prepared from an anticoagulant-free blood harvest
without any artificial biochemical modification that allows obtaining fibrin membranes
enriched with platelets and growth factors
Placing implants in the posterior maxillary area has the drawback of working with scarce,
poor quality bone in a significant percentage of cases. Numerous advanced surgical techniques
have been developed to overcome the difficulties associated with these limitations.
Subsequent to reports on the elevation of the maxillary sinus through the lateral approach,
there were reports on the use of the crestal approach, which is less aggressive but requires
a minimal amount of bone. Furthermore, it is more sensitive to operator technique, as the
integrity of the sinus membrane is checked indirectly. The main advantage of this new
technique, Intralift, is that it does not require a minimum amount of crestal bone (indeed,
the smaller the width of the crestal bone, the better this technique is performed). The
possibility of damage to the sinus membrane is minimized by using ultrasound based
hydrodynamic pressure to lift it, while applying a very non-aggressive crestal approach.
Conclusions: We believe that this technique is an advance in the search for less traumatic
and aggressive techniques, which is the hallmark of current surgery The buccal fat pad
appears at 3 months in utero and continuously grows until birth (9). It protrudes at the
anterior border of the masseter muscle and extends to the parotid duct, where it rests on the
buccopharyngeal fascia, which covers the buccinator muscle. There is little change in the
volume of buccal fat during aging, and it is approximately 10 mL
PRF is a natural fibrin-based biomaterial prepared from an anticoagulant-free blood harvest
without any artificial biochemical modification that allows obtaining fibrin membranes
enriched with platelets and growth factors
Sinus lifting procedures are performed routinely to provide the required height of proper and
stable bone tissue around the dental implants to be inserted. The surgical technique of
maxillary sinus Schneiderian membrane (MSSM) lifting with immediate/simultaneous installation
of dental implants, generally results in significant bone formation. The recently reported
graftless MSSM elevation procedure and the subsequent augmentation of bone have greatly
changed our perspective of bone neoformation potential. The blood clot formed under the
lifted MSSM appears to be of critical importance in bone neoformation potential, precluding
the need for exogenous graft materials
In elevation with the rotary technique, the main intraoperative complication is perforation
of Schneider's membrane, which is observed in between 10-35% of all such operations , and
which usually occurs in the osteotomy drilling phase while preparing the window for access to
the sinus . With the purpose of reducing the risk of perforating Schneider's membrane,
vestibule osteotomy using ultrasound has been proposed, as this reduces the risk of soft
tissue damage and percentage membrane perforation to 7%. Some studies in the literature are
preliminary descriptions of the technique, while others present isolated cases and others in
turn report case series - no significant differences being observed between the two
techniques
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